Health affairs
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The first decade of the patient safety movement achieved some real gains, focused as it was on adverse events amenable to systemwide solutions, such as infections associated with health care and medication errors. However, diagnostic errors, although common and often serious, have not received comparable attention. ⋯ Health information technology, better training, and increasing acknowledgment of the problem hold some promise. As approaches to measuring, preventing, and mitigating harm from diagnostic errors are proven to work, it will be important to integrate these approaches into policy initiatives to improve patient safety.
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Comparative Study
Many emergency department visits could be managed at urgent care centers and retail clinics.
Americans seek a large amount of nonemergency care in emergency departments, where they often encounter long waits to be seen. Urgent care centers and retail clinics have emerged as alternatives to the emergency department for nonemergency care. ⋯ There is some evidence that patients can safely direct themselves to these alternative sites. However, more research is needed to ensure that care of equivalent quality is provided at urgent care centers and retail clinics compared to emergency departments.
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The phrase "patient-centered care" is in vogue, but its meaning is poorly understood. This article describes patient-centered care, why it matters, and how policy makers can advance it in practice. ⋯ Policy makers need to look beyond such areas as health information technology to shape a coordinated and focused national policy in support of patient-centered care. This policy should help health professionals acquire and maintain skills related to patient-centered care, and it should encourage organizations to cultivate a culture of patient-centeredness.
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The culmination of a century's effort to enact universal coverage in the United States is a law with an uninspiring title, the Patient Protection and Affordable Care Act, and an even more awkward acronym, PPACA. The Obama administration has decided to call the legislation the Affordable Care Act, but the expansion of health coverage that the law sets in motion has no name, and therefore no identity. It badly needs one.
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The Patient Protection and Affordable Care Act makes major changes to the Medicare prescription drug benefit, reducing drug costs for many seniors and increasing rebates and other costs for industry. Although these changes will affect prescription drug costs and pharmaceutical companies' profits, they are unlikely to alter the trends already reshaping the pharmaceutical industry. By participating in crafting health care reform, instead of opposing reform as it did in 1993, the pharmaceutical industry avoided some potential threats to revenues and made accommodations that limited the overall federal costs of reform.